USDTL (United States Drug Testing Laboratory, Inc.) has succeeded in improving their umbilical cord screening assay for buprenorphine by reducing the positive result cutoff from 1.0 ng/g down to 0.5 ng/g. The improved umbilical cord buprenorphine assay gives the best possible detection of buprenorphine exposure, making it possible to identify more newborns exposed to buprenorphine in utero.
Buprenorphine Diversion: A Growing Problem
Buprenorphine is an opioid product used in the treatment of addiction to heroin, hydrocodone, and other opioid substances. Buprenorphine is able to bind to the addiction receptors normally affected by illicit opiate drugs, without the intense euphoric feeling from drugs such as heroin. Used by prescription in place of an addict's normal drug of choice, buprenorphine helps eliminate withdrawal symptoms that come with quitting illicit opiate substances.
The supply and distribution of buprenorphine to medical, pharmaceutical and treatment facilities has increased more than 100 times since 2003. Unfortunately, the diversion of buprenorphine for non-medical and illicit use has increased as well. In some areas, buprenorphine may be a cheaper alternative to heroin or prescription opiates. Addicts may use it to help bridge the gap until they can afford their next drug purchase. When a preferred drug is not available, addicts may turn to buprenorphine to tide them over and prevent withdrawal symptoms. Others may self-medicate with buprenorphine, hoping to quit their opiate addiction, but unable to afford the cost of a treatment facility.
In the latest statistics from the National Survey on Drug Use and Health, 5.9% of pregnant women admitted to use of an illicit substance during pregnancy. A study from the University of Michigan Health System found that opiate use during pregnancy, including buprenorphine, increased more than 370% between the years 2000 and 2009. Buprenorphine exposure in the womb, like other opiates, may cause newborns to experience low birth weight, respiratory distress, and neonatal abstinence syndrome (NAS). Babies experiencing NAS often require longer hospital stays following birth, and possible morphine administration to treat withdrawal symptoms.
States are required by the Child Abuse Prevention and Treatment Act to establish policies and procedures for reporting cases of newborns exposed to illegal substances to child protective services agencies, and to establish plans of safe care for these newborns. Forensic drug testing of newborn samples such as umbilical cord tissue is a tool for healthcare practitioners to identify prenatal substance exposure.
- Zev Schuman-Olivier, Mark Albanese, Sarah E. Nelson, Lolita Roland, Francyne Puopolo, Lauren Klinker, Howard J. Shaffer. Self-treatment: Illicit buprenorphine use by opioid-dependent treatment seekers. Journal of Substance Abuse Treatment, 2010; 39 (1): 41 DOI: 10.1016/j.jsat.2010.03.014
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